Healthcare Provider Details

I. General information

NPI: 1124939137
Provider Name (Legal Business Name): KATE HAGNER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S 10TH ST
LEBANON OR
97355-1300
US

IV. Provider business mailing address

485 S 5TH ST
LEBANON OR
97355-2602
US

V. Phone/Fax

Practice location:
  • Phone: 541-451-8534
  • Fax:
Mailing address:
  • Phone: 541-451-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: